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. 2020 Jun;28(3):e97.
doi: 10.1097/jnr.0000000000000371.

Changes in Health-Related Quality of Life for Older Persons With Cognitive Impairment After Hip Fracture Surgery: A Systematic Review

Wantonoro Wantonoro  1 , Wen-Yu Kuo  2 , Yea-Ing Lotus Shyu  3
Affiliations

Changes in Health-Related Quality of Life for Older Persons With Cognitive Impairment After Hip Fracture Surgery: A Systematic Review

Wantonoro Wantonoro et al. J Nurs Res. 2020 Jun.

Abstract

Background: Hip fractures in persons with cognitive impairments represent a major public health issue in older populations that often results in poor health-related quality of life (HRQoL).

Purpose: The aim of this systemic review was to examine the changes in HRQoL in older, cognitively impaired patients with hip fracture who had received surgical treatment.

Methods: A literature search of PubMed, Scopus, MEDLINE, PsycINFO, and CINAHL (EBSCO) databases was conducted for studies published up to July 2018 that addressed the issue of HRQoL in cognitively impaired patients with hip fracture after surgery. Studies that met the following criteria were included: Patients with hip fracture were over 60 years old and had cognitive impairment or dementia, patients had undergone hip fracture repair surgery, HRQoL was determined using standardized questionnaires, a descriptive or interventional methodology was used, and the full-text article was available in English.

Results: A primary search of databases yielded 1,528 studies, 621 duplicates were removed, and the remaining 907 abstracts were screened. Thirty-four full-text articles were deemed relevant for full review; of these, 10 articles met the criteria for inclusion in the review. Cognitive impairment was found to impact negatively on the patients' HRQoL after hip fracture surgery (n = 809). Severity of cognitive impairment was correlated with deterioration in HRQoL after hospital discharge. When compared with prefracture measures of HRQoL, the greatest deterioration in HRQoL postsurgery occurred during the first 4 months after discharge. Impacts on HRQoL for patients with cognitive impairment at later time points differed depending on type of hip fracture and type of surgical treatment. However, for most of the patients, HRQoL remained relatively unchanged at 6, 12, and 24 months postdischarge.

Conclusions: We recommend nursing care interventions for older persons with cognitive impairment be initiated immediately after surgery for hip fracture to prevent a significant decline in HRQoL. Further examination of interventions that are effective in maintaining HRQoL for these patients such as interdisciplinary care is necessary. In addition, the influences of hip fracture type and surgical approach on changes in HRQoL suggest a need for further investigations to determine what contributed to the observed inconsistencies in the outcomes.

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References

    1. Aguirre E., Kang S., Hoare Z., Edwards R. T., & Orrell M. (2016). How does the EQ-5D perform when measuring quality of life in dementia against two other dementia-specific outcome measures? Quality of Life Research, 25(1), 45–49. https://doi.org/10.1007/s11136-015-1065-9 - DOI
    1. Ankri J., Beaufils B., Novella J. -L., Morrone I., Guillemin F., Jolly D., … Blanchard F. (2003). Use of the EQ-5D among patients suffering from dementia. Journal of Clinical Epidemiology, 56(11), 1055–1063. https://doi.org/10.1016/S0895-4356(03)00175-6 - DOI
    1. Avcı C. C., Sağlam N., Saka G., Kurtulmuş T., Gülabi D., & Bulut G. (2016). Is internal fixation of the intertrochanteric fractures reliable option in patients with cognitive dysfunction? Acta Orthopaedica Belgica, 82(1), 1–11.
    1. Beaupre L. A., Jones C. A., Johnston D. W., Wilson D. M., & Majumdar S. R. (2012). Recovery of function following a hip fracture in geriatric ambulatory persons living in nursing homes: Prospective cohort study. Journal of the American Geriatrics Society, 60(7), 1268–1273. https://doi.org/10.1111/j.1532-5415.2012.04033.x - DOI
    1. Blomfeldt R., Törnkvist H., Ponzer S., Söderqvist A., & Tidermark J. (2005). Internal fixation versus hemiarthroplasty for displaced fractures of the femoral neck in elderly patients with severe cognitive impairment. Journal of Bone and Joint Surgery. British Volume, 87(4), 523–529. https://doi.org/10.1302/0301-620X.87B4.15764 - DOI

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